Prozac Diary

In 1988, at age 26, Lauren Slater lived alone in a basement apartment in Cambridge, depressed, suicidal, unemployed. Ten years later, she is a psychologist running her own clinic, an award-winning writer, and happily married. The transformation in her life was brought about by Prozac. Prozac Diary is Lauren Slater's incisive account of a life restored to/b>/b>

Overview

In 1988, at age 26, Lauren Slater lived alone in a basement apartment in Cambridge, depressed, suicidal, unemployed. Ten years later, she is a psychologist running her own clinic, an award-winning writer, and happily married. The transformation in her life was brought about by Prozac. Prozac Diary is Lauren Slater's incisive account of a life restored to productivity, creativity, and love. When she wakes up one morning and finds that her demons no longer have a hold on her, Slater struggles with the strange state of being well after a lifetime of craziness. Yet this is no hymn to a miracle pharmaceutical. It is a frankly ambivalent quest for the truth of self behind an ongoing reliance on a drug. Slater also addresses Prozac's notorious "poop-out" effect and its devastating attack on her libido. This is the first memoir to reflect on long-term Prozac use, and reviewers agree that no one has written about Prozac with such beauty, honesty, and insight.

Editorial Reviews

Christopher Lehmann-Haupt

[Slater] treats the drawbacks of Prozac with expressiveness. . . .what makes the book most worthwhile is her discussion of the subtler perils of Prozac. . . .her book. . .must surely be among the best ones available on the long-term effects of the drug. . . New York Times

Biography

...[B]eautifully written...

Rebecca Ascher-Walsh

Slater reminds us that a writer's true gift -- and power -- lies in the ability to generously turn what seems like a specific experience into a universal one. -- Entertainment Weekly

D. Max

...Slater is too capable an observer of her own psyche not to ask...what she may have lost....Does Prozac make you who you are or who you were never meant to be? For Slater...it's enough to bealmost and at lastwell. The New York Times Book Review

Peter Kurth

What are the actual chances
of a seriously disturbed adolescent girl, prone to
depression, eating disorders and self-mutilation,
emerging after years of treatment and repeated
psychiatric hospitalizations to become not only a
doctor of psychology but a writer of the first
rank, a woman whose work rises effortlessly to
the top of the list of "recovery" memoirs that
have flooded the market in recent years? Such a
woman is Lauren Slater, whose new book,
Prozac Diary, is as fine a chronicle of illness
and regeneration as you will ever read. Slater
writes like an angel, in a dreamy, joyously
reflective narrative that remains both intensely
personal and miraculously detached.

"How do you describe emptiness?" she asks. "Is
it the air inside the bubble, the darkness in a
pocket; snow? I think, yes, I was six, or seven
when I first felt it, the dwindling that is
depression ... Even back then, at the very
beginning, I carried myself with a kind of
confidence and verve, and I have yet to
understand how energy can so easily co-exist
with what is hollow." Prozac Diary is the
record of Slater's 10 years on the wonder drug,
first as a patient in clinical trials and later as a
reluctant but inexorable convert to the miracle of
psychotropics, with the attendant revelation that
she is not, and never can be, wholly "herself"
while swimming in a sea of chemicals. Slater was
long attached to the comforts of being ill, the
exemption sickness gave her from the experiences
of ordinary life. There is "a loss" in rising to your
feet, she says, in getting it all together, shopping
for furniture and looking for lovers, houses and
jobs.

"Much has been said about the meanings we
make of illness," says Slater, "but what about the
meanings we make out of cure? Cure is complex,
disorienting, a re-visioning of the self, either
subtle or stark. Cure is the new, strange planet,
pressing in ... I was definitely a different person
now, both more and less like me, a burgeoning
mystery fulfilling one destiny while swerving
from another." Along the way, Slater worries a
lot about the potential loss of her "creativity" -- a
baseless fear on the evidence of this book -- and
about the spiritual diminishment that Prozac
might cause in people whose deepest need is for
meaning. Entertaining a lover, she wants him
"just [to] lapse into senseless stanzas, into a
jungle of useless beauty, and proclaim something
smutty and gorgeous like, 'when I fuck you it's
sliding into a satin slipper, only softer and honey
to taste.'" Instead he tells her that "our whole
world is comprised of only five basic properties --
hydrogen, oxygen, nitrogen, magnesium, zinc."

"And truly there is a kind of primitive poetry to
that statement," Slater writes, "something
rhythmic and essential." Her "shame about being
drug-dependent is very American," her chemist
boyfriend tells her. Still uneasy, she stays the
course, likening Prozac to "Zen medicine" and
slowly coming around to "Prozac's point of view,
which posits god as a matter of molecules and
witchcraft as a neural mishap." It could be that
Prozac is "a conduit" to the essential self, Slater
thinks, "a kind of psychotropic draino clearing the
congestion so shine is visible." Her book, at least,
is a perfect jewel, rinsed clean of dreck and
psychobabble and pointing hopefully, cautiously,
to the Brave New World. -- Salon

Publishers Weekly - Publisher's Weekly

In the final chapter of Welcome to My Country, an account of her work with schizophrenic patients, psychologist Slater revealed that, she, too, had been institutionalized, and that she saw much of herself in those she counseled. Now she steps back to tell how fluoxetine hydrochloride (better known as Prozac) freed her from crippling obsessive-compulsive thoughts and suicidal impulses and allowed her to continue her education, have a career, fall in love and marry. The flipside to Elizabeth Wurtzel's brash, bratty rants, Slater's chronicle focuses not on her depressions ('At 15, right when my life should have been growing, it warbled and shrank to the size of a hard, black dot'), but on her long-term relationship with the drug, which she wryly characterizes as a dependency: 'We all have our teats. We all suckle something or other.' Earnestly reflective, Slater's book is a sort of coming-of-age story, that of a woman who spent her teens and early '20s in a limbo of symptoms and institutions, and had to learn to enjoy life once returned to it. Whether she describes her first weeks on the drug ('the air felt like flannel on my skin'), the Prozac 'Poop-out' and its attendant relapses or the vicissitudes of love and sex in her chemically altered state, Slater is frank, engaging and closely descriptive. Her worry that long-term use has diminished her creativity should be allayed by this luminous, cautiously optimistic memoir.

Kirkus Reviews

A perceptive and articulate young psychologist's revealing memoir of 10 years on Prozac, with all its blessings and curses. If Slater's first book, empathetic stories about her patients, Welcome to My Country, was remarkable for its self-revelations, this one is even more so. When Slater began taking Prozac in 1988, she was an intelligent but unemployed 26-year-old with obsessive-compulsive disorder and a long history of hospitalizations for depression, self-mutilation, and anorexia. Prozac changed her life. Despite the drug's slow-acting nature, within nine days she felt well, and the difficult job of learning to live a normal life began for her. While she felt it suppressed her energies, curiosity, and creativity, she discovered that her life became 'quiet but rich, a fine piece of music by Mozart.' She established a real home for herself, completed a doctoral program in record time, became a psychologist, director of a clinic, and a writer, and she fell in love. Long-term use eventually led to what she terms a 'poop-out,' and Prozac became 'a well-meaning buddy whose presence can considerably ease pain but cannot erase it.' Perhaps Slater's deepest regret about her dependence on Prozac for a normal life is the effect it has had on her sexuality, a subject she explores with great frankness and considerable grace. She also ponders the question of what Prozac in fact does: is it a sort of psychic steroid providing a competitive edge in life? Or is it, rather, a conduit to what Jung called the essential self? For Slater it has undoubtedly allowed her to become the person she isa psychologist with a keen sense of what it feels like to suffer the agonies of mental illness.Fortunately, despite her fears, it doesn't appear to have seriously dampened her creativity. Heartfelt but never mawkish; eloquent but never slick; a lyrical account of a drug that has caused mounds of controversy.

Read an Excerpt

WHERE HE WAITS

To get there, you turn left off the highway and drive down the road bordered on one side by pasture. And then, a radio song or so later, you turn right into the hospital's gated entrance, easing your car up the slope that leads to the turreted place where he waits. Safety screens cover all the windows. The stairs are steep, and exit signs cast carmine shadows on the concrete floors. Four flights you must travel, and then down several serpentine corridors, before you finally come to his office.

I had never been here before. I had never heard the word Prozac before. It was 1988, the drug just released. I was to be one of the first to take Prozac, and, even though I didn't know this then, one of the first to stay on it for the next ten years, experiencing what long-term existence on this new medication is actually like.

The Prozac Doctor is a busy man. He sees thirty, forty, sometimes fifty patients a day. He is handsome in ways you don't expect your medicine man to be. He has shining black hair and beautiful loafers made of leather so fresh you can practically see the hide still ripple with life. He wears one simple gold band on a finger as tapered as a pianist's, topped with a chip of nacreous nail sanded to perfect smoothness. He is host as well as doctor, and that first time, as well as every time thereafter, he invites me in, standing behind his desk and ushering me forward with stately sweeps of his hand, bowing ever so slightly in a room where you half expect caterers carrying platters of shrimp to emerge from the shadows.

"Sit, Ms. Slater," he said to me the morning we met. He gestured to a deep seat, and I sat. There was a silence between us then, a kind of weighted silence, a grand silence, like the sort you hear before a symphony begins.

And that day was the beginning, the bare beginnings of a story very little like the popular Prozac myths-a wonder drug here, a drug that triggers violence there. No. For me the story of Prozac lies not between these poles but entirely outside of them, in a place my doctor was not taught to get to-the difficulty and compromise of cure, the grief and light of illness passing, the fear as the walls of the hospital wash away and you have before you this-this strange planet, pressing in.

But that first day, there was just Prozac pressing in. I looked around me at the office. On the doctor's desk I saw a Lucite clock with the word prozac embossed across the top. I saw a marble mount holding four pens with prozac etched down their flanks. The pads of paper resting on his bookshelf were the precise size and shape of hors d'oeuvre napkins, and all had prozac in fancy script across their borders, like the name of some new country club."What is this stuff?" I asked. I heard my voice repeat itself in my ears, as so many sounds seemed to do lately, the screech of brakes, birdsong nipping at my brain.

The doctor leaned back in his seat. "Prozac," he said, "is the chemical compound fluoxetine hydrochloride." He told me it had a three-ring chemical structure similar to that of other medications I'd tried in the past but that its action on the body's serotonin system made it a finer drug. He told me about the brain chemical serotonin and its role in OCD-obsessive-compulsive disorder-the most recent of my many ills, for me the nattering need to touch, count, check, and tap, over and over again. He told me about synapses and clefts, and despite the time he took with me that day, I felt him coming at me across a gulf.

He had all the right gestures. His knowledge was impeccable. He made eye contact with the subject, meaning me. But still, there was something about the way the Prozac Doctor looked at me, and the very technical way he spoke to me, that made me feel he was viewing me generally-swf, long psych history, five hospitalizations for depression and anxiety-related problems, poor medication response in past, now referred as outpatient for sudden emergence of OCD-as opposed to me, viewing me, in my specific skin.

My skin: had little white lines on it from where I used to cut. It had always crisped easily in the summer sun.

My ears: knew the difference between real and imaginary sounds. That said, they sometimes heard voices, which doctors in the hospitals had told me was a sign not of psychosis but of dissociation. There was a blue baby who cried in my ears. There was a girl in a glass case, who talked to me. The world was full of many sounds-rushings, whirrings, soft and thunderous-and this was both a pleasure and a problem.

My hands: had become a problem. Once they had been conduits for pleasure. When I was a child they had held leaves and rabbits. Today, however, they were one of the reasons I was here. They were the part of me that seemed to have the OCD, tense and seeking, tapping things forty, fifty, sixty times. Not people, thank God, but objects, like stove switches, gas dials. Sometimes I looked at my hands and remembered them as they used to be, fine-boned, indigo-veined, lined with the tracery of all they had touched. Not now, though. From my hands I had learned grief. I had learned how the body can leave you, before you have left it.

I wanted to tell the Prozac Doctor about my hands. I wanted to splay them across his desk and say, "Look at them. What are they seeking?" I wanted him to touch my hands, not really an odd desire, the laying on of hands a practice as ancient as the Bible itself. The Prozac Doctor was biblical to me. I invited him to take on that role, the role every sick person needs her healer to play-not only technician, but poet, priest, theologian, and friend. I know this was asking a lot, poor man, but few people are as full of need and desire as the patient.

Instead, he reached down, opened a desk drawer, and pulled out a sample pill packet. He did not need to ask me many questions, as he had my entire chart before him, thick as an urban phone book. The packet was rather unimpressive, plain white, with a perforated top. To my surprise, he lifted it to his lips and tore at it with his teeth, then gently tapped at it until a smooth pill slid from its foiled pouch into the clean cup of his palm.

There it lay, cream and green. Tiny black letters were stamped down its side-dista-which sounded to me like an astronomy term, the name of a planet in another galaxy. On and on my mind went, making from this small capsule many private metaphors-it was candy, no poison; protein, no plastic.

I wanted to say these things to the Prozac Doctor. But he held himself so politely, angled away from contact. And, after all, he was a busy man, pressured by insurance companies to see throngs of patients, all with their own little paint box of multiple metaphors. Where would he have found the time to explore with me the private poem of the medicine that would soon be mine, a poem that had, as its first stanza, some song about failure? Having tried for the past three years to achieve stability on my own, determined to do it, I was here again, sick with this OCD. How could that be? I was incomplete, apparently, without the pill that was, among other things, a plug to stopper some hole in my soul. Perhaps the hole came from a neuronal glitch, the chemical equivalent of a dropped stitch in the knitted yarn of my brain. Or maybe the hole was between my mother and me. Because when I looked at the pill I also saw her, the little capsule of her sports car we would speed in, clean and compact, screeching to a halt in front of the florist's, where she bought armloads of orchids. And then to the butcher's, where she purchased great red wheels of beef. Nothing was ever enough, for there was no plug to stopper the hole in her soul, no pill.

My pill. Sitting, still, in the Prozac Doctor's palm but moving me backward in time, forward into hope. Much has been said about the meanings we make of illness, but what about the meanings we make out of cure? Cure is complex, disorienting, a revisioning of the self, either subtle or stark. Cure is the new, strange planet, pressing in. The doctor could not have known. And that made me, as it does every patient, only more alone.

"We will start," he said to me, "with twenty milligrams a day, a single capsule, although OCD, unlike depression, usually requires a higher dose." He showed me how, if the dose made me nauseous, I could split the pill and try half, and when I asked him what, exactly, was inside, he told me the story of the drug's design. He told me about Eli Lilly's campus in Indiana, where Prozac was first made, how a man raised rats and then ground their brains into something called a synaptosome, which became this medicine. He told me how Prozac marked a revolution in psychopharmacology because of its selectivity on the serotonin system; it was a drug with the precision of a Scud missile, launched miles away from its target only to land, with a proud flare, right on the enemy's roof.

I pictured the proud flare. I pictured the grounds of Eli Lilly, green and winding. Inside, the labs were clean. White-coated technicians were plucking the gray matter from rats, extracting the liquid transmitters, some kind of healing wet.

I hoped then.I hoped to be helped.

And yet, I did not take this new pill. Back at home, in the basement apartment where I lived, I looked and looked at it. I touched it to the tip of my tongue, then moved it away. This was not a tease, the drawn-out flirtation that will later come to love. This was fear. Maybe more than anything else, taking a pill, especially a recently developed psychotropic pill about which researchers have more questions than answers, is always an exercise in the existential, because whatever happens happens to your body alone. Each time you swallow a pill you are swallowing not only a chemical compound but yourself unmoored; you are swallowing the sea, the drift and the drown. A pill makes the inscrutable Sartre solid, brings to life the haunting solitude of a Munch painting. It is not the doctor's job to populate the painting, but if he has a flair for the medical arts, maybe he will. The Prozac Doctor, for all his style, couldn't. Psychopharmacology is the one branch of medicine where there is no need for intimacy; neither knives nor stories are an essential part of its practice. And in its understandable glee that it might finally move psychiatry into a position as respectable as surgery, it risks forgetting, or maybe never learning, what even many a surgeon knows: that you must smooth the skin, that you must stop by the bedside in your blue scrub suit, that language is the kiss of life.

I had a dream one night about the Prozac Doctor. This was four or five days after our first visit in what would become over a decade-long relationship. I dreamt I saw him in the supermarket and he was buying bread. He was in a dark suit with brass buttons, and he approached several loaves, newly baked, lying on wooden boards, each with a scar down its center. I knew the Prozac Doctor was hungry, because I could feel his pangs in me. I could feel how he wanted to crack the caul of his professional persona. I thought I should help him, that because I was a patient and knew about proneness and heat, I could, maybe, instruct. Perhaps this is the patient's task. Perhaps in every good medical encounter each party must try to save the other.

So I showed the Prozac Doctor the bread. I showed him how to test it for firmness, how to split it down its scar and spread the salve of butter on it. He lifted a loaf-honey-wheat, I think-and from the hidden folds of his jacket pocket took out a stethoscope. I nodded at him, and he pressed the stethoscope against the breast of the bread, eyes half closed, listening, listening, and then the bread breathed back-a rush and a whir-sounds both thunderous and soft in my ears. I woke up.

And later on that day I got up the courage to take my first dose. A dream doctor, apparently, can bear witness and hold out the promise of tenderness almost as well as a real doctor. It is very fashionable in medical science these days to talk about the power of visualization in healing. Your cancer cells are turning fresh as healthy heartland apples; your tumor is bearing milk. Although I say this tongue in cheek, I am serious too. Perhaps we should instruct patients, especially psychiatric patients, to visualize not only the transformation of their illness but the transformation of their doctors as well. Maybe out of such visualizations-insistent, intense, articulated-we will help to midwife our medicine men.

I held the pill in my hand and then washed it down with water. Afterward, things seemed so quiet. My eyes and ears were tilted inward, listening, looking. I felt what might have been a burning in my chest, something scampering up around my heart. Side effect? Serious? A start? It was too early to know. So I sat on a stool in my kitchen, and I conjured up the Prozac Doctor with his hand on a curve of crusty bread, the hide of fresh whole wheat. I stroked my own arm. I tried for calmness. I thought of yeast and how it works, bubbles of fermentation, little spheres of oxygen that must be kneaded, how maybe every good rising is a combination of chemicals and touch.

Meet the Author

A 1999 National Magazine Award nominee, Lauren Slater has a masters degree in psychology from Harvard University and a doctorate from Boston University. Her work was chosen for the Best American Essays/Most Notable Essays volumes of 1994, 1996, 1997, 1998, and 1999. Her previous book, Lying, was chosen by Entertainment Weekly as one of the top ten nonfiction books of 2000. Slater lives with her family in Massachusetts.

Customer Reviews

Most Helpful Customer Reviews

This book is a very well written and interesting memoir about the author's experiences with Prozac. Slater's writing has a pleasing, poetic quality that makes her book stand out among the best in the genre of mental illness memoirs. I'd say her writing is nearly as outstanding as that in Kay Jamison's 'An Unquiet Mind' and Susanna Kaysen's 'Girl, Interrupted'. The effects of the drug on Slater's OCD and borderline personality characteristics is also remarkable- she becomes 'better than well' and experiences the world as if being born anew. This is an excellent book that should be read by anyone interested in mental illness or anyone who enjoys reading well written memoirs.

Guest

More than 1 year ago

This book allows one to see inside depression. Although I work with people who suffer from depression, I found a world that was unfamillar and that I had not seen before. Slator has the courage to invite you into her world and let you see the world from her viewpoint.

Anonymous

More than 1 year ago

Anonymous

More than 1 year ago

Guest

More than 1 year ago

I wasn't really impressed by this book, at times it read to me a bit like a text book.